Compressed medical oxygen - Essential safety information - BOC: Living healthcare
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→ Medical Gas Data Sheet (MGDS) Compressed medical oxygen. Essential safety information. BOC: Living healthcare
02 Compressed medical oxygen Medical Gas Data Sheet
Summary of Product Characteristics (SPC)
1. Name of the Compressed medical oxygen.
medicinal product
2. Qualitative and Compressed medical oxygen cylinders are supplied to the following specification:
quantitative composition Compressed medical oxygen purity 99.5%(min)
The compressed medical oxygen cylinder specification complies with the current European Pharmacopoeia
monograph (0417).
3. Pharmaceutical form Medicinal gas, compressed.
4. Clinical particulars
4.1 Therapeutic indications Medical Oxygen is widely used in clinical practice to:
• provide a basis for most modern anaesthetic techniques including pre and postoperative management.
• restore the tissue oxygen tension towards normal by improving oxygen availability in a wide range of
conditions such as:
‐ cyanosis of recent origin as a result of cardio-pulmonary disease
‐ surgical trauma, chest wounds and rib fracture
‐ shock, severe haemorrhage and coronary occlusion
‐ carbon monoxide poisoning
‐ hyperpyrexia
‐ major trauma, i.e. road traffic accidents and gunshot wounds
‐ in the management of sudden cardiac and respiratory arrest, whether drug induced or traumatic
• aid in the resuscitation of the critically ill, when the circulation is impaired
• aid in neo-natal resuscitation
• treat acute severe headache in adults diagnosed with cluster headache
4.2 Posology and method of Medical oxygen is administered by inhalation through the lungs. The major exception is when a metered
administration supply is fed into the oxygenator of an extracorporeal circulation of a cardio-pulmonary by-pass system.
For cluster headache, oxygen should be administered as soon as possible after the onset of the attack, via a
non-rebreathing facemask at a flow of 6 to 12 l/min for approximately 15 minutes.
4.3 Contraindications There are no absolute contra-indications to the use of medical oxygen, but the inspired concentration should
be limited in the case of premature infants and those patients with chronic bronchitis and emphysema.
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© BOC Limited 2014Compressed medical oxygen Medical Gas Data Sheet 03
4.4 Special warnings and Special care is needed when medical oxygen is administered:
precautions for use • to neonates where the inspired concentration should not exceed 40% because of the risk of
retrolenticular fibroplasia
• to elderly chronic bronchitic patients in whom the inspired concentration should only be raised in stages
of 1% and probably should not exceed 30%
• in hyperbaric chambers in the management of conditions such as carbon monoxide poisoning, anaerobic
infections and acute ischaemic disease. Convulsions may occur at 3 bar (g) after a few hours.
Careful monitoring of oxygen levels on the breath, blood and tissue is required to ensure that appropriate
concentrations are not exceeded.
Where the patient has been exposed to agents which are toxic to the lungs, such as Paraquat, the use of
gases containing more than 21% oxygen should be avoided.
Compressed medical oxygen is non flammable but strongly supports combustion and should not be used
near sources of ignition. Compressed Medical Oxygen Cylinders should be set up and tested before placing
near the patient. Do not place the cylinder on the patient’s bed unless there is no suitable alternative for
retaining the cylinder.
Smoking should be prohibited when using compressed medical oxygen.
Under no circumstances should oils or grease be used to lubricate any part of the compressed medical
oxygen cylinder or the associated equipment used to deliver the gas to the patient.
Where moisturising creams are required for use with a facemask or in nasal passages, oil based creams
should not be used.
Check that hands are clean and free from any oils or grease.
Where alcohol gels are used to control microbiological cross-contamination ensure that all alcohol has
evaporated before handling compressed medical oxygen cylinders or equipment.
4.5 Interaction with other The use of higher levels of oxygen can increase the risk of pulmonary toxicity in patients who have been
medicinal products and other administered Bleomycin, Amiodarone and Nitrofurantoin or similar antibiotics. In these cases oxygen should
forms of interaction be administered with caution and at levels kept as low as possible.
4.6 Pregnancy and lactation Medical oxygen does not adversely affect pregnancy and lactation.
4.7 Effects on ability to drive and In normal circumstances, medical oxygen does not interfere with the conscious level but patients who
use machines require continuous oxygen support are obviously not fit either to drive or to operate machinery.
4.8 Undesirable effects Compressed medical oxygen toxicity can occur as manifested by:
• retrolenticular fibroplasia in premature infants exposed to oxygen concentrations greater than 40%
• convulsions appear after a few hours exposure to medical oxygen at pressures above 3 bar(g)
• retrosternal soreness associated with coughing and breathing difficulties, made worse by smoking and
exposure to cold air after breathing pure medical oxygen at atmospheric pressure for several hours.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows
continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are
asked to report any suspected adverse reactions via The Yellow Card System www.mhra.gov.uk/yellowcard
4.9 Overdose Overdose effects for medical oxygen are detailed in ‘Undesirable Effects’.
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© BOC Limited 201404 Compressed medical oxygen Medical Gas Data Sheet
5. Pharmacological
properties
5.1 Pharmacodynamic properties Pharmacotherapeutic group – medical gas
ATC code – V03AN01
The characteristics of medical oxygen are:
• odourless, colourless gas
• molecular weight 32.00
• boiling point -183.1ºC (at 1 bar)
• density 1.335 kg/m3 (at 15ºC).
Oxygen is present in the atmosphere at 21% and is essential for life.
The basal oxygen consumption in man is about 250ml/min for a body surface of 1.8m². It is reduced by about
10% during anaesthesia and natural sleep and by about 50% for a 10ºC fall in body temperature.
Alveolar air contains about 14% oxygen (105mm Hg) and the arterial blood has an oxygen tension of
97mm Hg. The difference, known as the alveolar-arterial oxygen tension gradient, increases with age. The
difference may be as great as 30mm Hg in a healthy, elderly individual.
Oxygen in the blood is mostly combined with haemoglobin. 1.34ml per 9ml to give a maximum capacity of
20ml per 100ml of blood. A small amount, 0.3ml, exists in solution in the same volume of blood.
The concept of oxygen availability first described by Richards in 1943 and later elaborated by Freeman and
Nunn has been used to quantify the amount available to the body.
It can be expressed as the product of cardiac output and the blood’s oxygen content.
Available oxygen is calculated by:
(cardiac output) x Hb concentration x 1.34 x (% saturation)
Substituting the normal values for available oxygen the amount is:
Available oxygen: ((5000ml) 15/100 x 1.34 x 95/100) = 950ml
The average healthy individual with a basal oxygen consumption has no more than four minutes supply of
oxygen in the blood.
5.2 Pharmacokinetic properties The uptake of medical oxygen by the blood in the lungs and discharge to the tissues is determined by the
oxygen dissociation curve. The characteristic sigmoid shape ensures that, at tensions between 40 and 15mm
Hg, the oxygen carried in the blood from the lungs can be readily given up to the tissues.
The uptake from the lungs is rapid, because blood flow through the capillaries, where exchange takes place,
occurs in about 0.5 seconds. The uptake of oxygen is favoured by the simultaneous loss of carbon dioxide
which is then excreted in the expired air. Conversely the entry of carbon dioxide into blood from the tissues
facilitates oxygen transfer to the cells.
At rest, mixed venous blood returning to the lungs contains 13-14ml of oxygen per 100ml, but with severe
exercise, the oxygen content may fall to 3-4ml. In very active tissue, almost complete extraction occurs.
5.3 Preclinical safety data The current published toxico-pharmacological data indicates that Medical Oxygen is not harmful to humans.
6. Pharmaceutical
particulars
6.1 List of excipients None
6.2 Incompatibilities Medical oxygen strongly supports combustion and will cause substances to burn vigorously, including
some materials that do not normally burn in air. It is highly dangerous in the presence of oils, greases, tarry
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© BOC Limited 2014Compressed medical oxygen Medical Gas Data Sheet 05
substances and many plastics due to the risk of spontaneous combustion in the presence of oxygen in
relatively high concentrations.
6.3 Shelf life 36 months
6.4 Special precautions Compressed medical oxygen cylinders should be:
for storage • stored under cover, preferably inside, kept dry and clean, and not subjected to extremes of heat or cold
and away from stocks of combustible material
• stored separately from industrial and other non-medical cylinders
• stored to maintain separation between full and empty cylinders
• used in strict rotation so that cylinders with the earliest filling date are used first
• stored separately from other medical cylinders within the store
• F size cylinders and larger should be stored vertically. E size cylinders and smaller should be stored
horizontally.
Warning notices prohibiting smoking and naked lights must be posted clearly in the cylinder storage area
and the Emergency Services should be advised of the location of the cylinder store.
Care is needed when handling and using compressed medical oxygen cylinders.
6.5 Nature and contents of A summary of oxygen cylinders, their size and construction, type of valve fitted and valve outlet pressure is
container detailed below:
Cylinder details Valve details
Size Gas Water Material of Valve type Nominal
content capacity construction Filling port valve outlet
(litres) (litres) Outlet connections pressure
Outlet flowrates bar(g)
AZ 170 1.2 Aluminium Valve type Non regulated 137
Outlet Pin Index
(BS EN 850)
ZA 300 1.0 Aluminium Valve type Integral regulated 4
(Carbon fibre Filling port ISO 5145 (oxygen)
hoop wrapped) Outlet 6 mm Fir Tree
Flowrate 0.1 – 15 litres/min
D 340 2.32 Steel Valve type Non regulated 137
Outlet Pin Index
(BS EN 850)
CD 460 2.0 Aluminium Valve type Integral regulated 4
(Kevlar hoop Filling port ISO 5145 (oxygen)
wrapped) Outlet (1) 6 mm Fir Tree
Flowrate 1 - 15 litres/min
Outlet (2) BS 5682 Schrader
Flowrate 40 litres/min (max)
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© BOC Limited 201406 Compressed medical oxygen Medical Gas Data Sheet
Cylinder details Valve details
Size Gas Water Material of Valve type Nominal
content capacity construction Filling port valve outlet
(litres) (litres) Outlet connections pressure
Outlet flowrates bar(g)
DD 460 2.0 Steel Valve type Integral regulated 4
Filling port ISO 5145 (oxygen)
Outlet 6 mm Fir Tree
Flowrate 2, 4 litres/min
ZD 605 2.0 Aluminium Valve type Integral regulated 4
(Carbon fibre Filling port ISO 5145 (oxygen)
hoop wrapped) Outlet (1) 6 mm Fir Tree
Flowrate 1 - 15 litres/min
Outlet (2) BS 5682 Schrader
Flowrate 40 litres/min (max)
E 680 4.68 Steel Valve type Non regulated 137
Outlet Pin Index
(BS EN 850)
F 1360 9.43 Steel Valve type MPR non regulated 137
Outlet BS 341 No 3 (top)
AF 1360 9.43 Aluminium/Steel Valve type MPR non regulated 137
Outlet BS 341 No 3 (top)
DF 1360 9.43 Aluminium/Steel Valve type Integral regulated 4
Filling port ISO 5145 (oxygen)
Outlet 6 mm Fir Tree
Flowrate 2, 4 litres/min
HX 2300 10.0 Steel Valve type Integral regulated 4
Filling port ISO 5145 (oxygen)
Outlet (1) 6 mm Fir Tree
Flowrate 1 - 15 litres/min
Outlet (2) BS 5682 Schrader
Flowrate 40 litres/min (max)
ZH 2400 8.0 Steel Valve type Integral regulated 4
(Carbon fibre Filling port ISO 5145 (oxygen)
hoop wrapped) Outlet (1) 6 mm Fir Tree
Flowrate 1 - 15 litres/min
Outlet (2) BS 5682 Schrader
Flowrate 40 litres/min (max)
ZX 3040 10.0 Steel Valve type Integral regulated 4
(Carbon fibre Filling port ISO 5145 (oxygen)
hoop wrapped) Outlet (1) 6 mm Fir Tree
Flowrate 1 - 15 litres/min
Outlet (2) BS 5682 Schrader
Flowrate 40 litres/min (max)
G 3400 23.6 Steel Valve type MPR non regulated 137
Outlet BS 341 No 3 (top)
J 6800 47.2 Steel Valve type MPR non regulated 137
Outlet Pin Index
(BS EN 850)
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© BOC Limited 2014Compressed medical oxygen Medical Gas Data Sheet 07
Cylinders
All cylinders used for the storage of compressed medical oxygen are manufactured from either high tensile
steel or aluminium.
The AZ, D, E, F, AF, DF, G and J size cylinders are designed with working pressure of at least 137 bar(g)
The CD, DD and HX size cylinders are designed with a maximum working pressure of 230 bar (g).
The ZA, ZD, ZH and ZX size cylinder are designed with a maximum working pressure of 300 bar(g).
The colour coding of the shoulders of compressed medical oxygen cylinders is white
(RAL 9010). The colour coding of the cylinder body is white (RAL 9010). Cylinders also
carry the oxygen name on the body of the cylinder.
For a limited period, cylinders may have black bodies. These cylinders do not have the
name oxygen on the body of the cylinder.
Oxygen
The programme to convert all compressed medical oxygen cylinders to white bodies
will be completed by 2025.
Cylinder valves
Compressed medical oxygen cylinders are supplied with two main types of cylinder
valves, dependent upon the cylinder filling pressure and the type of application.
Conventional cylinder valves are fitted to AZ, D, E, F, AF, G and J cylinders which are designed to be used
with a pressure regulator. All of these cylinders are fitted with valves with outlet connections that conform
to either ISO 407 (pin index) or BS 341 (5/8” BSP F) and are filled to 137 bar (g). The cylinder valves are
constructed from high tensile brass with a steel spindle fitted with a Nylon 6.6 insert.
ZA, ZD, CD, DD, DF, ZH, HX and ZX cylinders are fitted with valves that have an integral pressure regulator,
with an outlet pressure of 3 or 4 bar(g). These regulated valves are fitted with an ISO 5145 product specific
filling connection and either a product specific BS 5682 Schrader outlet connection or a standard 6mm fir
tree outlet. Integral cylinder valves are constructed from high tensile brass with a steel spindle fitted with a
Nylon 6.6 insert.
The internal valve components in the integral regulated valve are made from oxygen compatible materials,
designed to not produce poisonous fumes if the cylinder is subjected to high temperatures, causing ignition
of any of the valve components.
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© BOC Limited 201408 Compressed medical oxygen Medical Gas Data Sheet
6.6 Special precautions for All personnel handling compressed medical oxygen cylinders should have adequate knowledge of:
disposal and other handling • properties of the gas
• correct operating procedures for the cylinder
• precautions and actions to be taken in the event of an emergency.
Preparation for Use
Cylinders used with a pressure regulator
Sizes AZ, D, E, F, AF, G and J
To prepare the cylinder for use, before placing near the patient:
• remove the tamper evident seal and the valve outlet protection cap. Ensure the cap is retained so that it
can be refitted after use
• ensure the batch label fitted to the cylinder is not removed or discarded
• ensure that an appropriate compressed medical oxygen regulator is selected for connection to the cylinder
• ensure the connecting face on the regulator is clean and the sealing washer fitted is in good condition
• connect the regulator, using moderate force only and connect the tubing to the regulator/flowmeter
outlet. Only the appropriate regulator should be used for the particular gas concerned
• open the cylinder valve slowly and check for any leaks.
Cylinders with an integral regulated valve
Sizes ZA, ZD, CD, DD, DF, ZH, HX, and ZX
To prepare the cylinder for use, before placing near the patient:
• check the cylinder contents gauge on the cylinder valve to ensure that there is sufficient gas contents in
the cylinder
• remove the tamper evident seal and cover fitted over the valve outlets.
• ensure the batch label fitted to the cylinder is not removed or discarded
• ensure that the correct equipment is selected for connection to the cylinder
Connect as appropriate either:
• the appropriate sized tubing to the fir tree outlet
• the medical oxygen Schrader probe to the Schrader outlet (where fitted)
• open the cylinder valve slowly and check for any leaks
Leaks
Cylinders used with a pressure regulator
Sizes AZ, D, E, F, AF, G and J
Having connected the regulator or manifold yoke to the cylinder check the connections for leaks using the
following procedure:
• should leaks occur this will usually be evident by a hissing noise
• should a leak occur between the valve outlet and the regulator or manifold yoke, depressurise and
remove the fitting and fit an approved sealing washer. Reconnect the fitting to the valve with moderate
force only, fitting a replacement regulator or manifold tailpipe as required
• sealing or jointing compounds must never be used to cure a leak.
• Never use excessive force when connecting equipment to cylinders
• if leak persists, label cylinder and return to BOC
Cylinders with an integral regulated valve
Sizes ZA, ZD, CD, DD, DF, ZH, HX, and ZX
Check the connection for leaks using the following procedure:
• should leaks occur this will usually be evident by a hissing noise
• close valve, remove connection, check and refit
• never use excessive force when connecting equipment to cylinders
• if leak persists, label cylinder and return to BOC.
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© BOC Limited 2014Compressed medical oxygen Medical Gas Data Sheet 09
Use of cylinders
When compressed medical oxygen cylinders are in use ensure that they are:
• only used for medicinal purposes
• turned off, when not in use, using only moderate force to close the valve
• only moved with the appropriate size and type of trolley or handling device
• handled with care and not knocked violently or allowed to fall
• used with an appropriately designed cylinder support to hold the cylinder whilst in use adjacent to the
patient. Do not place the cylinder on the patient’s bed unless there is no suitable alternative for retaining
the cylinder
• not allowed to have any markings, labels or batch labels obscured or removed
• not used in the vicinity of persons smoking or near naked lights.
After use
When the compressed medical oxygen cylinders are empty ensure that the:
• cylinder valve is closed using moderate force only and the pressure in the regulator or tailpipe released
• valve outlet cap, where fitted, is replaced
• empty cylinders are immediately returned to an empty cylinder storage area for return to BOC.
7. Marketing authorisation BOC Limited
holder The Priestley Centre
10 Priestley Road
The Surrey Research Park
Guildford
Surrey, GU2 7XY
8. Marketing authorisation PL 00735/5000
number(s)
9. Date of first Date first granted 01/09/1972
authorisation/renewal of Date of renewal 21/07/1997
the authorisation
10. Date of revision of Date of revision 03/2014
the text
11. Dosimetry (if applicable) Not applicable
12. Instructions Not applicable
for preparation of
radiopharmaceuticals
(if applicable)
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© BOC Limited 201410 Compressed medical oxygen Medical Gas Data Sheet
Additional Safety Information
1. Contact information BOC telephone number to be used in the event of an emergency
UK 0800 111 333
2. Hazards Classification labelling and packaging regulations
Danger.
May cause or intensify fire; oxidiser (H270).
Contains gas under pressure; may explode if heated (H280).
Keep/Store away from clothing, hydrocarbons and combustible materials (P220).
Keep reduction valves free from grease and oil (P244).
In case of fire: stop leak if safe to do so (P370 + P376).
Protect from sunlight: store in a well-ventilated place P410 + P403).
Dangerous Preparations Directive
Contact with combustible material may cause fire (R8).
COMPRESSED OXIDISING Keep out of the reach of children (S2).
GAS AGENT
2 5.1 Keep away from combustible material (S17).
Label statements
• Contact with combustible material my cause fire
• No smoking or naked flames near medical oxygen cylinders
• Use no oil or grease
• Keep away from extremes of heat and combustible material
• Store cylinders under cover in a clean, dry and well ventilated area
Medical oxygen is supplied as a compressed gas in a high pressure cylinder.
Cylinders may explode if subjected to extremely high temperatures (if involved in a fire).
Medical oxygen is a non-flammable gas but is a very strong oxidant. It will strongly support and
intensify combustion.
It may react violently with combustible materials such as oils and grease.
3. Fire fighting measures If medical oxygen cylinders are involved in a fire:
• if it is safe to move the cylinders,
-- close cylinder valve to stop the flow of product
-- move cylinders away from source of heat
• if it is not safe to move the cylinders,
-- cool with water from a protected position.
All types of fire extinguishers may be used when dealing with a fire involving medical oxygen cylinders.
No special protective equipment for fire fighters is required. There are no hazardous combustion products
released from the gas.
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© BOC Limited 2014Compressed medical oxygen Medical Gas Data Sheet 11
4. Accidental release If a large volume of medical oxygen is released, if safe to do so, you should:
measures • close the cylinder valve
• where possible, isolate all sources of ignition
• if release continues, evacuate the area and ensure that the affected area is
• adequately ventilated before re-entry.
Self-contained breathing apparatus is not required to be used if oxygen is released in a confined area.
5. Exposure controls When using medical oxygen cylinders ensure adequate ventilation. If clothing becomes impregnated with
oxygen (due to a leak), keep away from sources of ignition or open flames. Clothing impregnated with
oxygen should be ventilated in fresh air for a minimum of 15 minutes.
6. Disposal considerations It is recommended that medical oxygen cylinders should not be vented after use – they should be returned
to BOC, with any residual gas, where they will be vented before refilling in a safe environment.
If, for safety reasons, a cylinder is required to be vented after use, the gas should be vented to atmosphere
in a well ventilated area.
Contact BOC if further guidance on venting cylinders is required.
7. Transport of cylinders When medical oxygen cylinders are required to be transported, ensure that the cylinders are:
• located in a compartment separated from the driver
• adequately restrained
• not leaking and have their valves closed.
The vehicle must be adequately ventilated. Ensure the driver is aware of the potential hazards of the load
and knows what to do in the event of an accident or an emergency.
It is advisable to provide the driver with written instructions that detail the actions to be taken in the event
of an accident or emergency. Cylinders should be removed from the vehicle as soon as possible.
8. Use of cylinders in transit – If you need to use medical oxygen within a vehicle, you are advised to:
advice to patient/carer • prohibit smoking in the vehicle
• only carry the minimum number of cylinders to provide sufficient gas for patient use during the
journey/activity
• ensure all cylinders are adequately restrained
• keep cylinder valves closed when not in use
• avoid using the cylinder when the vehicle is being refuelled
• set the ventilation system to fresh air or open a window to provide adequate ventilation and to prevent
oxygen enrichment within the vehicle
• avoid leaving cylinders unattended in a vehicle. Unless the vehicle is specifically designed to carry
medical oxygen cylinders,they should be removed from the vehicle overnight.
9. Transport information UN number UN1072 oxygen, compressed
Material Class 2
Labels 2.2, 5.1
Hazard identification number 25
Emergency Action Code 2s
Tunnel Restriction Code E
Transport category 3
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© BOC Limited 2014HLC/507770/UKS/0414 BOC Healthcare Customer Service Centre, Priestley Road, Worsley, Manchester M28 2UT Tel 0800 111 333, Fax 0800 111 555, bochealthcare-uk@boc.com, www.bochealthcare.co.uk The stripe symbol and the letters BOC are registered trade marks of The BOC Group Limited. Both BOC Limited and The BOC Group Limited are members of The Linde Group, the parent company of which is Linde AG. Reproduction without permission is strictly prohibited. © BOC Limited 2014
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